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Katzelnick LC, Quentin E, Colston S, Ha TA, Andrade P, Eisenberg JNS, Ponce P, Coloma J, Cevallos V. Increasing transmission of dengue virus across ecologically diverse regions of Ecuador and associated risk factors. PLoS Negl Trop Dis 2024; 18:e0011408. [PMID: 38295108 PMCID: PMC10861087 DOI: 10.1371/journal.pntd.0011408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 02/12/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
The distribution and intensity of viral diseases transmitted by Aedes aegypti mosquitoes, including dengue, have rapidly increased over the last century. Here, we study dengue virus (DENV) transmission across the ecologically and demographically distinct regions or Ecuador. We analyzed province-level age-stratified dengue incidence data from 2000-2019 using catalytic models to estimate the force of infection of DENV over eight decades. We found that provinces established endemic DENV transmission at different time periods. Coastal provinces with the largest and most connected cities had the earliest and highest increase in DENV transmission, starting around 1980 and continuing to the present. In contrast, remote and rural areas with reduced access, like the northern coast and the Amazon regions, experienced a rise in DENV transmission and endemicity only in the last 10 to 20 years. The newly introduced chikungunya and Zika viruses have age-specific distributions of hospital-seeking cases consistent with recent emergence across all provinces. To evaluate factors associated with geographic differences in DENV transmission potential, we modeled DENV vector risk using 11,693 Aedes aegypti presence points to the resolution of 1 hectare. In total, 56% of the population of Ecuador, including in provinces identified as having increasing DENV transmission in our models, live in areas with high risk of Aedes aegypti, with population size, trash collection, elevation, and access to water as important determinants. Our investigation serves as a case study of the changes driving the expansion of DENV and other arboviruses globally and suggest that control efforts should be expanded to semi-urban and rural areas and to historically isolated regions to counteract increasing dengue outbreaks.
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Affiliation(s)
- Leah C. Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Emmanuelle Quentin
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Savannah Colston
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Thien-An Ha
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Paulina Andrade
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Patricio Ponce
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Varsovia Cevallos
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador
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Huang Y, Mustapha J, Harrison-Williams L, Fashina T, Randleman C, Ifantides C, Shantha JG, Yeh S. Global Ophthalmic Health Initiatives in Ebola and Emerging Infectious Disease Outbreaks: Implications for Vision Health Systems, Program Implementation, and Disease Surveillance. Int Ophthalmol Clin 2023; 63:79-89. [PMID: 36598835 PMCID: PMC9819215 DOI: 10.1097/iio.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Guillot C, Bouchard C, Aenishaenslin C, Berthiaume P, Milord F, Leighton PA. Criteria for selecting sentinel unit locations in a surveillance system for vector-borne disease: A decision tool. Front Public Health 2022; 10:1003949. [PMID: 36438246 PMCID: PMC9686450 DOI: 10.3389/fpubh.2022.1003949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives With vector-borne diseases emerging across the globe, precipitated by climate change and other anthropogenic changes, it is critical for public health authorities to have well-designed surveillance strategies in place. Sentinel surveillance has been proposed as a cost-effective approach to surveillance in this context. However, spatial design of sentinel surveillance system has important impacts on surveillance outcomes, and careful selection of sentinel unit locations is therefore an essential component of planning. Methods A review of the available literature, based on the realist approach, was used to identify key decision issues for sentinel surveillance planning. Outcomes of the review were used to develop a decision tool, which was subsequently validated by experts in the field. Results The resulting decision tool provides a list of criteria which can be used to select sentinel unit locations. We illustrate its application using the case example of designing a national sentinel surveillance system for Lyme disease in Canada. Conclusions The decision tool provides researchers and public health authorities with a systematic, evidence-based approach for planning the spatial design of sentinel surveillance systems, taking into account the aims of the surveillance system and disease and/or context-specific considerations.
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Affiliation(s)
- Camille Guillot
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada,*Correspondence: Camille Guillot
| | - Catherine Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Philippe Berthiaume
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - François Milord
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrick A. Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada
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Kavulikirwa OK, Sikakulya FK. Recurrent Ebola outbreaks in the eastern Democratic Republic of the Congo: A wake-up call to scale up the integrated disease surveillance and response strategy. One Health 2022; 14:100379. [PMID: 35313715 PMCID: PMC8933533 DOI: 10.1016/j.onehlt.2022.100379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/03/2022] Open
Abstract
Ebola virus disease (EVD) is a dangerous viral zoonotic hemorrhagic fever caused by a deadly pathogenic filovirus. Frugivorous bats are recognized as being the natural reservoir, playing a pivotal role in the epidemiological dynamics. Since its discovery in 1976, the disease has been shown to be endemic in the Democratic Republic of the Congo (DRC). So far, thirteen outbreaks have occurred, and EVD has been prioritized in the national surveillance system. Additionally, EVD is targeted by the Integrated Disease Surveillance and Response (IDSR) strategy in DRC. The IDSR strategy is a collaborative, comprehensive and innovative surveillance approach developed and adopted by WHO's African region member states (WHO/Afro) to strengthen their surveillance capacity at all levels for early detection, response and recovery from priority diseases and public health events. We provide an overview of the IDSR strategy and the issues that can prevent its expected outcome (early detection for timely response) in eastern DRC where there are still delays in EVD outbreaks detection and weaknesses in response capacity and health crisis recovery. Therefore, this paper highlights the advantages linked to the implementation of the IDSR and calls for an urgent need to scale up its materialization against the recurrent Ebola outbreaks in eastern DRC. Consequently, the paper advocates for rapidly addressing the obstacles hindering its operationalization and adapting the approach to the local context using implementation science.
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Affiliation(s)
- Olivier Kambere Kavulikirwa
- Faculty of Veterinary Medicine, Université Catholique du Graben de Butembo, Democratic Republic of the Congo
| | - Franck Katembo Sikakulya
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
- Faculty of Medicine, Université Catholique du Graben de Butembo, Democratic Republic of the Congo
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Du M, Jing W, Liu M, Liu J. The Global Trends and Regional Differences in Incidence of Dengue Infection from 1990 to 2019: An Analysis from the Global Burden of Disease Study 2019. Infect Dis Ther 2021; 10:1625-1643. [PMID: 34173959 PMCID: PMC8234762 DOI: 10.1007/s40121-021-00470-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Dengue, as a neglected tropical disease, brings a heavy socioeconomic burden. To provide tailored global prevention strategies, we analyzed the global trends and regional differences in incidence of dengue infection from 1990 to 2019. METHODS We obtained data on annual dengue episodes and incidence rates, which reflected the epidemic status of dengue infection from the 2019 Global Burden of Disease (GBD) Study. The changes in dengue episodes and estimated annual percentage changes (EAPCs) of the age-standardized incidence rate (ASR) were calculated to quantify the temporal trends of dengue infection. RESULTS Globally, dengue ASR increased by 1.70% (95% CI 1.62%-1.78%) per year from 1990 to 2011; subsequently, it decreased by 0.41% (95% CI 0.20%-0.62%) per year from 2011 to 2019. However, the global number of dengue episodes increased steadily by 85.47% from 30.67 million in 1990 to 56.88 million in 2019. Against the global trend of decreasing ASR from 2011 to 2019, an increasing trend was reported in Oceania (EAPC 11.01, 95% CI 8.79-13.27), East Asia (EAPC 4.84, 95% CI 2.70-7.03) and Southeast Asia (EAPC 0.38, 95% CI 0.13-0.62). For socio-demographic index (SDI) regions, ASR continued to have an increasing trend in the middle (EAPC 0.26, 95% CI 0.07-0.45) and high-middle (EAPC 1.70, 95% CI 0.98-2.42) SDI regions from 2011 to 2019. In contrast to the global peak age of dengue incidence rate (10 to 25 years), the dengue incidence rate of older people (> 65 years) was higher than in other age groups in low and low-middle SDI regions. Additionally, the proportions of dengue episodes in the > 70-year-old age group increased in 2019 (using the baseline in 1990 or 2011) in most GBD regions. CONCLUSIONS Global dengue episodes have increased tremendously in 3 decades. Although global dengue ASR decreased in the last decade, it is still increasing in hyperendemic regions including Oceania, East Asia and Southeast Asia, and also in the middle and high-middle SDI regions. More attention should be paid to the elderly because of the higher dengue incidence rate among them in low and low-middle SDI regions and the increased proportions of dengue episodes among the elderly in most GBD regions. Therefore, more efforts should be undertaken to develop targeted prevention strategies for crucial regions and older populations.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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de Macêdo SF, Silva KA, de Vasconcelos RB, de Sousa IV, Mesquita LPS, Barakat RDM, Fernandes HMC, Queiroz ACM, Santos GPG, Filho VCB, Carrasquilla G, Caprara A, de Oliveira Lima JW. Scaling up of Eco-Bio-Social Strategy to Control Aedes aegypti in Highly Vulnerable Areas in Fortaleza, Brazil: A Cluster, Non-Randomized Controlled Trial Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031278. [PMID: 33572650 PMCID: PMC7908398 DOI: 10.3390/ijerph18031278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
Aedes aegypti is a cosmopolitan vector for arboviruses dengue, Zika and chikungunya, disseminated in all Brazilian states. The Eco-Bio-Social (EBS) strategy is vital in Aedes aegypti control as it mobilizes stakeholders (government, professionals, society, and academics) to promote healthy environments. This paper describes the rationale and methods of expanding the EBS strategy for Aedes aegypti control in Fortaleza, Northeast Brazil. A cluster, non-randomized controlled clinical trial was developed to analyze the strategy’s effectiveness in vulnerable territories (high incidence of dengue and violent deaths; low HDI; substandard urban infrastructure, high population density, and water scarcity). We selected two intervention and two control groups, resulting in a sample of approximately 16,000 properties. The intervention consisted of environmental management by sealing large elevated water tanks, introduction of beta fish in waterholes, elimination of potential breeding sites, and mobilization and training of schoolchildren, endemic disease workers, health workers, social mobilizers, and community leaders; community surveillance of arboviruses; construction and validation of a booklet for the prevention of arboviruses in pregnant women. We analyzed the costs of arboviruses to government and households, the intervention cost-effectiveness, chikungunya’s chronicity, and acceptance, sustainability, and governance of vector control actions. The primary outcome (infestation) was analyzed using the house, container, and Breteau indices. We hope that this study will help us understand how to scale up strategies to fight Aedes aegypti in vulnerable areas.
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Affiliation(s)
- Suyanne Freire de Macêdo
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
- Nursing Department, Federal University of Piauí, Picos 64607-670, Brazil
- Correspondence:
| | - Kellyanne Abreu Silva
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Renata Borges de Vasconcelos
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Izautina Vasconcelos de Sousa
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Lyvia Patrícia Soares Mesquita
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Roberta Duarte Maia Barakat
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Hélida Melo Conrado Fernandes
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Ana Carolina Melo Queiroz
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Gerarlene Ponte Guimarães Santos
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Valter Cordeiro Barbosa Filho
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
- Federal Institute of Education, Science and Technology of Ceará, Aracati Campus, Aracati 62800-000, Brazil
| | | | - Andrea Caprara
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - José Wellington de Oliveira Lima
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
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Chis Ster I, Rodriguez A, Romero NC, Lopez A, Chico M, Montgomery J, Cooper P. Age-dependent seroprevalence of dengue and chikungunya: inference from a cross-sectional analysis in Esmeraldas Province in coastal Ecuador. BMJ Open 2020; 10:e040735. [PMID: 33067302 PMCID: PMC7569951 DOI: 10.1136/bmjopen-2020-040735] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES There are few population-based estimates for prevalence of past exposure to dengue and chikungunya viruses despite common epidemiological features. Here, we have developed a novel statistical method to study patterns of age-dependent prevalence of immunity in a population following exposures to two viruses which share similar epidemiological features including mode of transmission and induction of long-lasting immunity. This statistical technique accounted for sociodemographic characteristics associated with individuals and households. SETTINGS The data consist of a representative sample from an ongoing longitudinal birth cohort set-up in a tropical district in coastal Ecuador (Esmeraldas). PARTICIPANTS We collected data and blood samples from 319 individuals belonging to 152 households following epidemics of the infections in 2015 in Latin America. PRIMARY OUTCOME Plasma was tested for the presence of specific IgG antibodies to dengue and chikungunya viruses by commercial ELISA and defined a bivariate binary outcome indicating individuals' past exposure status to dengue and chikungunya (ie, presence/absence of IgG antibodies to dengue or chikungunya or both). RESULTS Dengue seroprevalence increased rapidly with age reaching 97% (95% credible interval (CrI): 93%-99%) by 60 years. Chikungunya seroprevalence peaked at 42% (95% CrI: 18%-66%) around 9 years of age and averaged 27% (95% CrI: 8.7%-51.6%) for all ages. Rural areas were more likely to be associated with dengue-only exposure while urban areas and shorter distance to the nearest household were associated with exposures to both. Women living in urban settings were more likely to be chikungunya seropositive while rural men were more likely to be dengue seropositive. CONCLUSION Dengue seroprevalence was strongly age dependent consistent with endemic exposure while that of chikungunya peaked in childhood consistent with the recent emergence of the virus in the study area. Our findings will inform control strategies for the two arboviruses in Ecuador including recommendations by the WHO on dengue vaccination.
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Affiliation(s)
- Irina Chis Ster
- Institute of Infection and Immunity, St George's University of London, London, UK
| | | | | | - Andrea Lopez
- International University of Ecuador, Quito, Ecuador
| | - Martha Chico
- International University of Ecuador, Quito, Ecuador
| | | | - Philip Cooper
- Institute of Infection and Immunity, St George's University of London, London, UK
- International University of Ecuador, Quito, Ecuador
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